The Rise and Fall of Paternalism in Radiation Protection

The Rise and Fall of Paternalism in Radiation Protection

Health Physics Society56th Annual Meeting, West Palm Beach, Florida

TPM-E.4, Tuesday, June 28, 2011Daniel J. Strom, Ph.D., CHP

Pacific Northwest National LaboratoryStrom@PNNL.gov

+1 509 375 2626Link to Abstract

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Outline• Motivation: Who’s responsible for safety?• The current radiation protection paradigm• Failures of the current paradigm• Empowering the protectee• Conclusions

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Motivation

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Radiation Protection

• Is the profession concerned with protecting humankind and the environment from the harmful effects of ionizing radiation– known as “health physics” in some countries

• Because technologies that produce radiation have significant benefits, protection must be provided without “just saying no”

• Radiation protection professionals must collaborate with users of radiation and radioactive materials to ensure safe practices

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Traditional Hierarchy of Radiation Protection

PhilosophySources and Effects

of Ionizing RadiationSocietal Norms

and Values

Recommendations:Justification, ALARA, Dose Limits

Regulations: Licensing, Inspection, Enforcement

UNSCEARScience Academies

Licensee, Employer and OwnerRadiation Protection Programs

Quantitiesand UnitsMeasurements

Workers Public

Patient Families

Patients

Environment

NormativeStandards

ICRP, NCRP, etc.

ICRU, ISO, IEC, ANSI, IAEA, etc.

Professional orPerformance Standards

Treaties

IAEA, IATA, ILO, INPO, JCAHO, etc;

Banks, Insurers, Manufacturers

NationalCompetent Authorities

Employers and HealthCare Providers

EntitiesNeeding Protection

Governments

Protectors

Protectees

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Traditional Hierarchy of Radiation Protection

• This paternalistic system does not empower the protectee to protect herself or himself

Parent

Child

Protector

Protectee

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Who Is Empowered to Act?• the United Nations and governments• legislators• regulators• managers• engineers and health physicists• workers• health care professionals• law enforcement personnel• first responders• individual members of the public

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Individual members of the public • Can take many of the same actions to protect themselves

and their families as can workers and managers• Additional choices

– where to live– remediate dwellings if they have high radon levels– make appropriate risk-management lifestyle choices (such as

not smoking)– not to have needless medical exposures

• elective whole-body CT scans in the absence of symptoms• repeated radiological exams by different health-care providers

– prepare for and respond to accidents and emergencies by sheltering in place or evacuating and by stocking and using potassium iodide if needed

– In some circumstances, individual and familial protection needs may not be met by the traditional system of radiation protection

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Individual members of the public • Empowered to protect by

– their own self-interest– their responsibility to keep their families safe (especially

parents caring for children)– education and training– accurate information about the radiological situation and what

actions they can take

• Disempowered by – ignorance– apathy– fear– paternalism of the traditional paradigm

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How are individuals or groups empowered to take protective actions?

• Many sources of empowerment– treaties, laws, regulations, recommendations, and

guidance

– administrative procedures

– design, creation, and maintenance of engineered barriers

– medical care

– education and training

– provision and use of personal protective equipment

– posting and labeling

– self-preservation

Done foror to

individuals

Done by individuals

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Empowering the Protectee to be the Protector:

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10 Principles and 10 Commandments of Radiation Protection

No. Principle Commandment (familiar)

1. Time Hurry (but don't be hasty)

2. Distance Stay away from it or upwind of it

3. Dispersal Disperse it and dilute it

4. Source Reduction Make and use as little as possible

5. Source Barrier Keep it in

6. Personal Barrier Keep it out

7. Decorporation (Internal & Skin)

Get it out of you and off of you

8. Effect Mitigation Limit the damage

9. Optimal Technology Choose best technology

10. Limitation of Other Exposures

Don’t compound risks (don’t smoke)

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Protectors must…• Have quantitative, or at least qualitative, knowledge of

the potential or actual radiological situation• Understand

– what principles and commandments they are empowered to enact

– what resources are needed for successful protection• Be able to judge what is reasonable, in the sense of

optimization, and when protective action is unnecessary• Protectors may have to account for

– individual differences in either susceptibility to effects of radiation

– age, sex, and pregnancy status are significant risk factors– need or desire for protection– triage following an accident or radiological attack may result in

differing efforts for decontamination

Empowering protectee to be protector: Civil Defense

• USA during the 1950s

• Natural extension of protection against aerial bombardment experienced during World War II

• Civil Defense (CD) organization created to protect the public from a nuclear attack

• CD provided training, information, and radiological survey instruments to organizations and individuals

• CD empowered individual members of the public to protect themselves and their families in situations to which the government could not conceivably respond effectively

• One hallmark slogan of that era taught to schoolchildren was “duck and cover”

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Empowering the Protector: Duck and Cover

• “Duck and cover,” meant that if there were a bright flash, children were to duck under furniture and cover their heads

• Besides its protection against flash blindness and flying debris, this was excellent advice that could be life-saving for individuals given that initial nuclear radiation persists for 10 or more seconds

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Survivalist Literature

• Old Civil Defense literature

• Allen Brodsky’s Actions For Survival: Saving Lives in the Immediate Hours After Release of Radioactive or Other Toxic Agents

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Case Studies • Unlicensed radium

• Unlicensed radionuclides in wastewater

• Chernobyl: Vitaly Eremenko’s Experience

Unlicensed Radium

• Mid-1980s, Colorado School of Mines

• Classroom in 1893 National Historic Landmark

• 226Ra chemist had worked there 50 years earlier

• 1.5 mSv/hour in one location at gonad level

• How much of the building goes in a waste drum?

• Ra-contaminated asbestos “snow” 20 cm deep in basement

• No licensee, no regulator, no one to report doses to

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A Combined Sanitary and Storm Sewer System:King County’s West Point Treatment Plant

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Sewer Lines Are Generally Buried

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Sewer Lines Are Generally Buried

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Pump Station

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Wet Well at Pump Station

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Combs Clear Debris from Bar Screens

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Screenings Go to a Dumpster

60Co Pellets (like at Juarez, 1983)

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mm- to cm-sized Grit

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Secondary Clarifier

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After Leaving Anaerobic Digestion, Biosolids Are Concentrated

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Concentrated Biosolids Are Collected for Shipment

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4-5 48 Tonne (105,000 lb.) Biosolids Trucks/Day• Biosolids shipped east for agricultural application

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Agricultural Application of Biosolids

• 4-5 trucks per day

Photo courtesy Michael A. Smith

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Potential Exposure Locations

• wastewater in pipes on the way to the plant

• regulator and pumping stations

• wastewater in the treatment plant

• slime and coated surfaces in treatment plant

• screenings in plant• screenings in dumpster at

disposal site• grit in plant

• grit in dumpster at disposal site

• biosolids in digesters• biosolids in trucks• biosolids applied to crops• crops eaten• resuspended dust from

biosolids• treated water• untreated water (bypass)

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Chernobyl: Vitaly Eremenko’s Experience

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Success: The traditional paternalistic paradigm works for• developed countries with significant government

infrastructure

• foreseeable uses of radiation and radioactive material– energy, propulsion, medicine, research, industry, space

travel

• environmental remediation

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Opportunity:The traditional paradigm fails for

• clandestine releases– Hanford’s Green Run; Chernobyl

• unregulated sources of radiation exposure– orphan sources; indoor radon; medical exposures

• nuclear or radiological attack– war; terrorism

• developing nations

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Conclusions• Traditional, paternalistic radiation protection

paradigm: institutions protecting people and the environment

• There are situations in which it doesn’t work or doesn’t work well

• There is need for improvement in informed individual protection actions has been demonstrated

• People can learn to protect themselves, and we should make that learning happen

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References• Brodsky A. 2009. Actions for Survival. Protections from Nuclear,

Chemical and Biological Terrorism. http://www.mjrpublications.com/New-Actions-For-Survival.html

• Eremenko VA, Droppo Jr JG. 2006. A personal experience reducing radiation exposures: protecting family in Kiev during the first two weeks after Chernobyl, Health Phys 91(2 Supp):S39-S46

• Hickey EE, Strom DJ. 2005. Technical basis for radiological emergency plan annex for WTD emergency response plan: West Point Treatment Plant. PNNL-15163 Vol. 3. Richland, Washington, Pacific Northwest National Laboratory

• Strom DJ. 1996. Ten principles and ten commandments of radiation protection. Health Phys. 70(3):388-393. Available by permission of the journal at http://www.pnl.gov/bayesian/10Principles.pdf

• Strom DJ. 2008. "Who's Empowered to Protect? How Are They Empowered? What Do They Need to Know? in Proceedings of the 12th International Meeting of the International Radiation Protection Association, ed. AJ González, IRPA, Buenos Aires. http://www.pnl.gov/bayesian/strom/pdfs/Strom2008F_PNNL-SA-61159_Whos_Empowered_to_Protect.pdf